Use Your Optima Health Drug Rehab Coverage to Pay for Addiction Treatment

If you or someone you love is looking for a rehab that takes Optima Health insurance, call today at 252-715-3905 to have our team run a confidential, no-cost verification of your benefits, or click here to complete our insurance form to get help today.

If you’re worried about your relationship with substances, there is help available. It can be extraordinarily difficult to come to terms with a substance use disorder, but accepting you have a problem is the first step. At Changing Tides, we’re an affordable treatment center that accepts Optima Health rehab coverage. Read on to find out more about Optima Health rehab coverage.

Optima Health is based in Virginia, and it provides services to individuals and employers. Employer-sponsored plans are Optima POS plans, Optima Plus and Optima Vantage.

Optima Vantage is an HMO plan, which means you get affordable access to medical care provided you work with an in-network rehab clinic. Optima Plus is a PPO plan, which means you can attend an out-of-network facility at an additional cost. POS plans give you the best of both worlds, with extra out-of-network benefits.

Read on to learn about the policy coverage for addiction and how Changing Tides accepts most Optima Health rehab plans (employer-sponsored and individual policies).

Optima Health Drug Rehab Coverage Options

Optima Health breaks down its coverage into three categories: bronze, silver and gold. All Optima Health rehab plans contain a deductible. Your policy will outline what you need to contribute with regards to coinsurance pays and co-pays.

The three tiers of Optima Health rehab insurance are:

• Bronze: Bronze is the best option for people who are at very low risk of needing health care. Low monthly premiums mean more out-of-pocket costs if you do require treatment.
• Silver: With a silver plan, you should expect to pay average monthly premiums and moderate coinsurance or co-pays at the point of care.
• Gold: While you pay a higher monthly premium on a gold plan, you’ll pay less out-of-pocket in case you do need treatment.

Is Outpatient Rehab Included in My Optima Health Policy?

Optima Health Insurance plans usually cover outpatient treatment, whether it’s a step-down from more intensive treatment or your first step. The main caveat is that your treatment is a medical necessity. If you have health insurance with your employer, coverage depends on the tier. Patients either pay a coinsurance fee of between 0% and 40% or a co-pay of between $150 and $300 after they’ve paid deductibles.

If you’re on an individual Optima Health drug rehab plan, you’re still responsible for co-pays and deductibles. Depending on your policy, you’ll pay a coinsurance cost of between 5% and 20% or a co-pay of between $10 and $40.

In-Network and Out-of-Network

You can use Optima Health alcohol rehab insurance for out-of-network services, but the fees are often sky-high. For the best price, seek treatment in an in-network drug rehab clinic.

Does Optima Health Insurance Cover Day Treatment/ Partial Hospitalization Programs?

As long as your treatment is medically necessary, Optima Health insurance should cover all or some of a day treatment/ PHP. If you have insurance through your employer, you’ll need to pay a portion of your co-pays. Coinsurance is equivalent to between 20% and 40% of the costs after deductibles.

On an individual plan, you can expect to pay between 5% and 30% of the costs of a day treatment/ PHP, unless you have the OptimaFit Catastrophic Plan. In this case, the entire duration of your stay at our Optima Health rehab might be covered.

Does Optima Health Cover Accommodation?

If you suffer from a severe substance use disorder, you might require intensive treatment in a residential setting. In many cases, your Optima Health rehab insurance will pay some of your accommodation costs. However, unless you have the most comprehensive plan offered, you’ll need to contribute towards your accommodation costs.